A skin biopsy is a procedure in which the dermatologist removes a tiny bit of skin. This is done to make a diagnosis and plan the treatment. In some cases, the skin lesion may be removed completely (excisional biopsy) as a part of the treatment or for cosmetic reasons. This is a very simple test done under local anesthesia. The testing of the biopsy specimen is done by the pathologists who are specially trained in this field.
The amount of information that your doctor has got from your consultations and/or blood tests may not be sufficient to come to conclusion or diagnose your illness. Your doctor may also need some more evidence to confirm the diagnosis and plan the treatment and hence has ordered this test for you.
Skin biopsies or excisions are done by the dermatologists treating you or any of his colleagues or assistants in the department well versed with the procedure.
There are predominantly four types of biopsies and the doctor will decide which one is being done on you. All these are done under local anaesthesia to make the area numb and you will not know any pain during the procedure
Shave biopsy: A thin layer of skin is shaved off from the top and around the suspected lesion.
Punch biopsy: A pen like instrument called a punch is used to remove a circular section through all layers of the lesion.
Excisional biopsy: A surgical blade [scalpel] is used to take off the entire lesion. This method is used for smaller lesions.
Incisional biopsy: The doctor uses a scalpel to remove a small sample of a large lesion.
Shave biopsies do not usually need stitches, while punch, excisional, and incisional biopsies will usually be closed with sutures and they can be removed at your local hospital or in your dermatologist’s office at your convenience.
You need not take any particular precautions prior to the procedure. You may have your normal diet before and after the procedure and you can wear normal clothing when you come for the procedure, provided the site chosen for biopsy can be easily accessed. It would be ideal if you get someone along to help you if the need arise.
Before the skin biopsy, kindly inform your doctor if you have any of the following
Known allergic reactions to any medications or local anaesthetics in the past
Known bleeding disorder
Have experienced excessive bleeding after other medical procedures
Taking blood-thinning medications, such as aspirin, aspirin-containing medications, warfarin (Coumarin) or heparin
History of skin infections, including impetigo or Herpes lesions on the face
Taking medications that suppress the immune system, such as diabetes medications or medications used after an organ transplant
Keloidal tendency
This will help him to plan and take precautions prior to the procedure and adjust your medications appropriately.
Being a very small procedure, risks are relatively less. Still, allergic reactions to dressings, rubber gloves, skin antiseptic solutions, or local anaesthetics may occur uncommonly. Please make sure to let your doctor know if you are allergic to any of these items. In addition to the above mentioned complications, like any procedure, skin biopsy also may bring about other complications like-local swelling and pain, wound infections, scars, keloids etc
This treatment is well tolerated by most of patients. However, some patients experience mild pain and burning sensations. Local anesthesia is usually not required.
Ideally the procedure takes only about ten to fifteen minutes. The entire procedure would be over in half an hour maximum.
When the local anaesthetic wears off (around 1-2 hours later) the wound will be a little painful sometimes, and there may be some limitation of movement. Whether this discomfort will be significant or just a minor hindrance will depend on where the wound is and how big it is. The tablets that your doctor has given you would be sufficient to overcome the discomfort. The discomfort would ideally reduce after 3 to 4 days. If the pain gets worse after 4 days it usually means there is an infection and you should seek medical help.
As with any cut or skin injury there is always a risk of bleeding. For this reason, a dressing is usually required and you will be instructed on how to deal if such a problem arises. It will be necessary to restrict your activity in the days following some types of skin biopsies like large/deep excision/wedge biopsies on the extremities etc. And in that case the doctor will specifically advise you accordingly. Otherwise restrictions are not mandatory. Vigorous exercise may stretch the wound, causing it to bleed or burst. You are advised to get in touch with your dermatologist or report to the hospital if you need any medical help.
The skin around the wound will be swollen. It can normally last for 3-4 days depending on the nature, size and site of the procedure. Bruising is also common which may last for 5-7 days. The dressing needs to be taken care of well, since it is a cut on the skin and the need to prevent infection is paramount. Wetting the surface may be avoided while taking bath. If the dressing is soiled, it will need to be removed as wet dressings make infections more likely.
In all probability, you are likely to have a scar following the procedure; although, it may not be very noticeable. The chances vary as each case is different and depends on a number of factors including the nature of the procedure, the site and your age. If there is a danger to structures such as nerves or tear ducts being cut or injured during the procedure, these possibilities will be discussed with you beforehand by the doctor doing the procedure.
A skin biopsy usually doesn’t prevent you from returning to your routine work the very next day. However, if you don’t find it very comfortable, especially if the biopsy site is on areas that may affect your activities, you are advised to refrain from heavy work till the wound heals or the sutures are removed.
Yes. You may be prescribed tablets and creams to be applied on the suture site depending on the biopsy type and the site etc. However it is not always necessary and the decision will be done by your doctor.
Mostly likely not. However, if the pathologists advise further evaluation or a repeat test immediately or on follow up, you may have to undergo the same accordingly. All these matters will be discussed with you by your doctor along with your test report.
The suture may sometimes fall off on its own or you may get it removed at your nearest health care centre after a week’s time. If you don’t have a facility in your neighbourhood, you may get it done at the clinic itself as advised.
It may take anything from one week to three weeks time to get the results. This will depend on your test type and the laboratory dealing with your sample. You may fix an appointment and meet the doctor accordingly.
Disclaimer: This article is only for general patient information and is not intended for self medication. There is no legal liability of IADVL arising out of any adverse consequence to the patient. Subsequent to its use for self treatment of the disease images adjust for the depiction of the condition and is not to be used for any other purpose.
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